7 Takeaways on the State of the Home Health Industry

By Kourtney Liepelt | November 9, 2016

The home health industry in 2016 has been riddled with staffing challenges, technology adoption and changes to clinical and operational processes. Some situations agencies have taken in stride, while others they continue to struggle with, according to a survey conducted by consultancy firm Fazzi Associates.

The survey, titled “State of the Home Health Industry,” consists of responses from 751 home health and hospice agencies across all 50 states, touching on staffing models, clinical practices, technology and more. Here are seven key takeaways on the current state of the home health industry, according to the survey.

1. Tablets are key.

More and more, agencies are relying on tablets and iPads to collect information directly from patients, as opposed to laptop computers. Whereas 27.3% of agencies used tablets/iPads for documentation in the 2013-14 survey, 49.9% did so in the 2016 survey.

“It’s much more about real-time information to support better care,” Timothy R. Ashe, partner at Fazzi Associates, said Wednesday during a webinar on the survey results. “Tablets enable clinicians in the field to be freer.”

2. Tech adoption rates depend largely on vendors.

The length of time it takes an average clinician to be fully competent in using point of care technology varies greatly, with 36.4% of agencies saying it takes their staff more than four weeks to completely master the technology and 32% noting it takes two weeks or less. However, the type of technology employed plays a significant role in how quickly the technology can be adopted.

Agencies reported significantly longer adoption periods for some point of care technology vendors than others, according to the survey, meaning it’s important to ask about the ease of implementation up front.

3. The impact of telehealth is significant.

Of the agencies that reported using telehealth or remote monitoring systems, 62.6% saw unplanned hospitalizations go down, and 50.9% saw the same for emergent care. Meanwhile, 74.9% of those agencies noted an uptick in overall quality, 59.5% a boost in patient self care, and 63.4% improved patient satisfaction.

“It’s one of the tools in the toolbox, and we believe that it has to be part of that care management toolbox,” Ashe said. “…If home health and hospice don’t own its use, then another sector of health care will.”

4. The number of visits nursing staff perform per day directly affects financials and quality.

Most agencies surveyed reported they expect five or six routine visits per day on average from their nursing staffs, at 36.9% and 36.7% of agencies, respectively. Taking that one step further, 27% of agencies in the top quartile for quality and profitability expect an average of five visits per day from their nurses, and 35.4% expect six visits.

5. It’s tough to hire workers who are qualified for the job.

Staffing woes are nothing new for home health and hospice agencies, and the Fazzi survey reaffirms this. For example, 48.1% of agencies said it’s somewhat difficult to hire well-qualified field nurses, and 32.5% said it’s very difficult. Similar figures were reported for physical therapists, clinical staff and even senior level leaders.

This should prompt agencies to especially begin thinking about succession plans, as well as training for supervisory management, according to Bob Fazzi, managing partner for Fazzi Associates.

Additionally, 64% say the biggest challenge for private duty is staffing, including recruitment and retention.

Across the board, agencies report concerns around staffing (10%), reimbursement (25%), changes and new regulations from the Centers for Medicare & Medicaid Services (12%) and financial stability (7%).

7. The year ahead will bring consolidation.

Although 70.5% of agencies say they believe their businesses will remain the same in the next 12 months, the remainder expect changes in operations. For 3.6%, that means they’re considering merger and acquisition opportunities, and 10.8% of agencies are considering acquiring other agencies, specifically. Meanwhile, 3.7% say they’ll consider selling their agencies.

This is the result of market pressures around bundled payments and other such changes to the home health environment, which require agencies to look and operate differently in order to be successful, Ashe said. As such, the market will surely be active.